My 2 year old daughter is using the Medtronic Revel insulin pump, with the Sure-T infusion sets. We have been experiencing lots of highs and ketones at night and think that it could be due to her laying on the site and kinking it. Does anyone else have experience with this? We typically use arm sites and belly sites. She loves to sleep on her sides and belly and will really fight us when we try to roll her on the opposite side she wants to lay on. This is frustrating and we are now in a situation where we have to wake up and check to see if she has rolled over on it multiple times throughout the night to avoid serious problems. Any advice or similar experience would be appreciated!
In our experience, it is virtually impossible to kink tubing. And since there is no "kinking" a SureT site, you can rule that out too. If the problem occurs only at night (i.e., when she gets up, her numbers go back down), I'd assume she simply needs more insulin for those nighttime hours. I'd increase basals and see what happens.
We use Sure-T's and site failure is generally towards the bottom of my "why is she high" checklist. Have you ever tested for ketones at night when she isn't high? I don't have diabetes experience with a toddler, but if I recall correctly others here have mentioned that their toddlers will show starvation ketones from a missed meal or from normal overnight fasting.
Tubing is extremely hard to kink. I would look at other reasons for high bg's and ketones.. I'd test through the night. My daughter has always needed double the amount of insulin between 6pm and 10pm than in the afternoon...
I agree with the others. My son has the Revel with Sure-Ts, and kinking hasn't ever been a problem for him. Raising the basal rate (or the dinnertime/bedtime snack bolus rate, depending on the pattern) would be my best guess. Good luck getting to the bottom of it all!
I just switched my son to an angled set this week, since the straight sets just stopped working for us. They would fail at night and he would wake up with high numbers. With the angled sites the numbers are back to normal. We are also trying new site locations which also contributed to the problem.
My 2 year old daughter is also using the Revel pump but we have the Mio inserters. She is a belly sleeper and we have only used sites just above her tush and on her sides. She wears her pump in pockets sewn on the back of her shirts All that being said, I have noticed that the sites aren't lasting as long (max of 2.5 days -- we used to get to 3 days no problem). Not sure if this is due to summer weather -more sweating and rough playing outside or if the site location are over used? Anyhow, I was thinking this may be your case as well. Hope you solve the mystery --Diabetes with 2 year olds is tough!!
Morning, My DD was Dx at 10months and is now 4.5yrs. We have used sites on her arms, legs, stomach, bum, and sides. We use an Animas pump and infusion sets. We have not found her to compress a site or kink her tubing at night. I'm thinking she just might need a little more basal at night.
